DESCRIPTION (Adapted from Applicant's Description): Persons with traumatic brain injury (TBI) experience high rates of depression in the years following their injury. Neurological and psychosocial factors appear to contribute to depression in this population. Depression following TBI is associated with poor physical, cognitive, behavioral, and functional outcomes. Preliminary studies suggest that major depression following TBI is treatable and that pharmacotherapy is associated with improvement in activities of daily living, neuropsychological and social functioning, work and subjective distress. Unfortunately, depression is under-recognized after traumatic brain injury, and optimal treatment for depression has not been established. To address this gap in the clinical care of patients with traumatic brain injury, the investigators will plan a randomized controlled pharmacotherapy trial of an antidepressant medication in this population. This trial will test the efficacy of antidepressant medications, not only to reduce depression-related symptomatology, but also to improve functional outcomes, neuropsychological test performance, social functioning, community integration, head injury-related symptoms, and health care costs. The investigative group includes researchers with expertise in all these areas including neuropsychiatry, physical medicine and rehabilitation, neuropsychology, health services research, epidemiology, and biostatistics. The group has conducted randomized controlled drug trials and large scale longitudinal studies of inpatients with traumatic brain injury. In collaborating with the University of Alabama, the investigators will have access to a large patient population in order to plan and eventually conduct a pharmacotherapy trial. Results from a successful trial are expected to lead to improved clinical care and functional outcomes for thousands of persons with TBI and comorbid depression throughout the country.